Provider Demographics
NPI:1194403584
Name:BAUGHMAN, QUINNTON (CRC)
Entity type:Individual
Prefix:
First Name:QUINNTON
Middle Name:
Last Name:BAUGHMAN
Suffix:
Gender:M
Credentials:CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6403 GRANT CT SW
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52404-7480
Mailing Address - Country:US
Mailing Address - Phone:319-329-6672
Mailing Address - Fax:
Practice Address - Street 1:400 S CLINTON ST
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52240-4105
Practice Address - Country:US
Practice Address - Phone:319-351-1110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-06
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA217884101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional